A patient diagnosed with hepatic encephalopathy is prescribed with lactulose. The medication treats liver cirrhosis by the following actions except:
  1. It decreases the pH of the bowel
  2. It decreases ammonia production by the bacteria
  3. It promotes ammonia excretion.
  4. It reduces the number of colonic bacteria that convert urea and amino acids into ammonia.
Explanation
Answer - D - Lactulose decreases ammonia levels, improves protein tolerance, and lowers colonic pH that results in ammonia excretion. Neomycin is used to reduce the number of colonic bacteria that produces ammonia.
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